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nx in :nio o�:�o r:�.� 1(i01i.i:t04:tL cnic�i� ¢sr nc <br />f�oox: oou <br />ELECTRICAL PERMIT APPLICATIOIV <br />CITY OF EVERETT PERMIT SERVICES g_,o �p <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 • FAX 426•257-8857 — www.everettwe.org �/ 06�—� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�Z_�-� ��',� sE. � � <br />PROJFCTADDRESS <br />�4� <br />Tonent <br />ElotVlcal Contnctor <br />M.n naan.. <br />M�II AEGrM� <br />AOCnu <br />�/��P l/lE_.1=1�/�'�— <br />Slate Uoante Number <br />— l��/l <br />Prnpoeed Uee ol Bulldinp <br />Deecnplion nf Work lo Be Done. ��L� ��/� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIREO TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERlTT LOCAL 9ALE9 TAX CODE 18 �106 <br />Ciry <br />Clly <br />Clty <br />�GO -�N� /� %� <br />Phons <br />SIYIeQIp / Pl��onp� <br />�� -f/�S9'/�i // <br />/Sunrz�p Pnone� <br />`�`�l Y � <br />Contrect Price of Work <br />�ILy � O slll� L��.�.� <br />Conleq Peroon (Plen Rewew� <br />I heroby certHy Me! 1 beve med en� o, yrrrinod this npPlicahon and know the same to Do truo and <br />corroot Allprow91on5 ollewS anp aiJ+nances yooeming fh:e type olwork will be comploled <br />Kho;hor spocifietl hB�oln or nol 7'ho prantinp cl e permd does nof �esume fo prve euNonty ta <br />v�ninfo or cencel fhe pruvisions ol ony ofher sfofe or �ocol law ieguP6np cronstrucfion o� fhe <br />perh�rmence ol cunslrucfron. � nnf I onr eufhon:od Ay fhn ownorol Mis �roperty Io pedorm tho <br />M�+�� br whrch appbcafion �5 mBr'o end I mm�ly �5vi� fho S'ate COntroc(Or5 Law 19.17 RCW and <br />176 20:% N'A C- <br />FEE <br />EiivK-�u <br />